SIGNS SYMPTOMS AND THE MANAGEMENT APPROACH TO COVED 19 DISEASE

signs symptoms and the management approach to coved 19 disease

     signs and symptoms and the management approach to coved 19 disease which is caused by SARS cough - or the current pandemic causing virus so before we introduce about the signs and symptoms couple of things that we need to keep in mind number one on average for 81% of the population that gets sick about two weeks later they have recovered on average so there is a good news that majority of the population becomes okay within two weeks and you would see as I talked about it that most of this most of the time they do not need a lot of management needs other than supportive management second thing to keep in mind is that there are people who are going to have the virus and they would still be asymptomatic which means they would have no symptoms.

Two type of groups one are younger children and youngsters

       In that has two type of groups one are younger children and youngsters so people in children from 0 to 10 years or than 10 to 20 years of age and even 20 to 30 years they may not actually have the symptoms at all they will get infected some people are saying that children are not getting infected no they can get infected they can even shed the virus that means they can give it to you but they themselves luckily fortunately do not develop a lots of symptoms and fortunately between 0 to 10 there has been no death as well so these are all good news is however the bad part in there is that when a child or a youngster has the disease is infected but they do not show symptoms they would look healthy to you and me and to themselves and if they are near us and they are shedding the virus in their breath or from their aerosol or from their 4 might then we will other people would continue to become infected from then.

Second are older people group

The people who are older they can actually become critically or severely ill as well so keep that in mind second group that may not have symptoms yet but may be shedding virus may be at a lower volume but still shedding virus are the people generally who become sick who received the virus but they are in the incubation period incubation period means that we have the virus it is replicating in us and it is still in lower quantities that it did not cause enough problem that it shows up as signs and symptoms but it is still being shed that amount and volume is low so it is not very very dangerous but still these folks are shedding who are in the incubation period.

Incubation period according to w-h-o

    From 2 days that means if I get the virus today within 2 days I may develop symptoms to 14 days which means if I get the virus today then after 14 days I develop the symptoms median is 5 days which is what that means is that 50% of the population would start showing symptoms within 5 days so these are the folks who are running around around us and they're healthy and they're fine but they are shedding viruses so they keep this in mind that it is possible that there are asymptomatic people who are infected and are making others infected now the severity of the disease so the question that may be in your mind is how do I know that I am sick and what is it that would tell me that I have corona virus so number one there is nothing that would tell you that there is corona virus other than suspicion that the symptoms that you may have are for the corona virus this can be actually normal called seasonal cold and flu symptoms as well so it's difficult to say Corona until you test it.

 What W-H-O has said on symptom?

W-H-O says that out of 400 people who become ill 81 percent of the people would develop mild symptoms and so the mild stage of the disease is when there is only fever 98 percent of the people would develop fever low-grade fever 101 and then with that dry cough 78 percent of the people would develop dry cough so if you have dry cough and the fever there is a chance that you have corona virus but this could be seasonal flu and cold as well so how do you further know it according to W-H-O if in addition to these symptoms you have been in contact with someone who was a confirmed case of corona virus then you are a suspect or you are a suspected case of corona virus or if you have been in an area which is the outbreak area for example Wuhan or Italy or some other areas where the outbreak is going on then there is also a chance to expect that you may be a suspected case but generally if you have developed fever and dry cough my advice would be to isolate yourself and wait it out and see what happens and if it becomes I'm going to talk about this serious case afterwards that is when you should go you should talk with the doctor in this case as well but in serious cases you actually have to talk with the doctor so this is the mild case .

 What are symptom ?

 you would look for fever and dry cough there may be possibility that you would have pneumonia like symptoms as well so throat may be there some chest tightness may be there in some cases the muscle fatigue and body aches maybe they're even diarrhea can be present sometimes there can be blood from the lungs as well hemoptysis we call it but generally fever and dry cough that is a first stage if that is the case stay at home isolate yourself and usually within two weeks with normal supportive management drink a plenty of water take vitamin D take Paris tamal maybe take some cough syrup eat well consult with general physician so your immune system is healthy and wait it out now in 14% of the cases the situation becomes serious and what is the indication of serious symptom is when somebody develops shortness of breath shortness of breath or Disney a-- as we call it difficulty in breathing for the way we define that is that the same things that you use to do without an issue now you are doing them and you have a problem you become breathless so let's say going up the stairs or walking around in the home or doing normal things that you used to do now when you're doing it you becoming breathless that is called shortness of breath as soon as you develop that no word that this is the serious case now why because that means the virus has gone into the lungs and it is causing damage in the lung tissues now and the interstitial pneumonia may be developing so that is when you must talk with the doctor they would suggest you to come in the hospital they would figure out how to bring you there and how to keep you isolated and then give you oxygen and take care of you.

most common symptom are

• dry cough
• fever
• tiredness   

Less common symptoms:

aches and pains

sore throat

diarrhea

conjunctivitis

headache

loss of taste or smell

     a rash on skin, or discoloration of fingers or toes 

Serious symptoms:

difficulty breathing or shortness of breath

chest pain or pressure

loss of speech or movement

When you go to the hospital ?

They would do further tests on you and they would find out that most of the case according to the WH or the further criteria is that the oxygen saturation that is the oxygen in your blood percentage is usually 99% and in such cases when you are just you're short on breath that is when the oxygen is below 93% this is why your shortened breath your body is saying I need more oxygen and your lungs are not able to bring the oxygen because the virus is damaging the lungs and so you have less oxygen to work with and you you feel short and breath the other thing that you would see or the doctors would see is that there is a thing called PF ratio and that is the partial pressure of oxygen in the arterial blood divided by the fraction of oxygen in the inspired air and normally it is a better fraction but in case of this situation the fraction is going to be below 300 so when it goes below 300 that means that there is an issue with the oxygenation as well with that when they do chest x-ray they would see that 50% of the lungs may be infiltrated with the inflammation or there is viral indications on the land 50% or more and that happens within 24 to 48 hours so all of these are indicators that this is a serious situation you will then need management with oxygen and other supportive therapies in the hospital.

 The critical case this is normally 5% of the patients

 Usually those are elder and the critical cases when there is septic shock there develops and septic shock is when the blood vessels died late because of the toxins that bacterias producing and the inflammatory response of the body blood vessels just open up and because they dilate they cannot maintain the blood pressure so now there is double whammy on one and there is not much oxygen because the lungs are damaged and then there is not much blood pressure to bring the oxygen to every part of the body so the organ systems that do not receive enough oxygen and blood they would start dying or becoming damaged in that renal failure can occur cardiac issues can occur and other systems can start getting damaged of course lungs are already getting damaged so this is a multiple organ failure situation acute respiratory distress syndrome will develop as well and this patient would need ventilation and normally it is very difficult to have a good prognosis but still please remember this 5% are critical 14 percent are serious 81 percent are mild cases and out of the whole number about 4% of the people would die so that's an that's not a good number but also realize that there is 96 percent of the people who would recover and become okay so these are the cases or the stages of intensity so if you have my fever and dry cough isolate yourself suspect you may have corona virus assume you have corona virus and just do not interact with others if you have developed shortness of breath talk with the doctor right away and normally you would start developing septic shock at home unless you just did not talk with anyone and just try to wait it out septic shock usually from serious to critical occurs in the hospitals. when the ventilation would be needed.

 What is the management it is a new virus? What abut vaccine?

          We do not have a vaccine for it they are trying to create a couple of ways there are many researches that are going on for the vaccines but the couple of ways that they're creating vaccines are number one the virus has a protein called a spike protein that binds with our ace two receptors on our cells and that binding causes the virus to be pulled into the cell so they are trying to see that can they do something with this Spyke protein and kind of block it in some way or damage it in some way so it cannot bind with the ASN it cannot be pulled in so that is one way to create vaccines and they are working on it the other one is that they are looking at the people who got infected developed immunity became recovered.

What is plasma theropy?

Plasma serum taken from blood of corona recovered patent and we are seeing if they have antibodies against the spike proteins in them and we are trying to then manufacture those spike proteins for Masse's so these are just a couple of ways I'm sure that there are more other ways as well that vaccines are being developed but we do not have a vaccine today and also please remember SARS go over the species that was 2002 to 2004 any immunity to that does not give immunity to SARS cough - that means these are two separate modified viruses so that immunity or those antibodies do not work with this one on the medical side on the antiviral side there are a couple of drugs so first I want to talk about the WH OHS message so I have the WHS message here they said there are no known effective antivirals for corona virus infection this is directly from the whi site and with that they say various conditions with potential and T and Co of activities are being evaluated various candidates for the clinical trials use of unregistered or unproven therapeutics for corona virus or SAS cough - should be done under strict monitoring and ethical approval so and they have given the given a message there to look at the module 15 and of course there is no module 15 over there so anyways that is a gap on their end.

The two drugs that have been used and high demand in world

That are rammedasevere and chloroquine there are more but these are the two that are becoming more popular chloroquine is a drug that has been used for malaria and HIV or AIDS as well it is an interesting drug what it does is it goes into our cells and why virus uses parts of our cells machinery to make more viruses so this drug goes in them and increases their pH that means it makes them less acidic and virus needs a little more acidic environment to work in so when the pH is increased the they the environment is less acidic virus cannot replicate very well so that is one way that chloroquine reduces the replication frequency of the virus and it is known to have done that with Tsarskoe of the previous one this one does it do or not they are doing the lots of limited trials and they're trying to do Studies on that the second thing that chloramine does which is really very interesting is that remember the ACE 2 receptors I talked about that our cells have ace 2 receptors which have the spike protein from the virus and it pulls it into the cell the chloroquine takes one last part of the receptor when the receptor is being formed it takes its last part and does not let it become glycosylated so that's a medical term but there is not glucose attachment is removed so the shape of the es 2 is not exactly the same as normal and that somehow negatively impacts the binding so virus binding reduces which then of course pulling of the virus in the cell reduces as well so that is what chloroquine does with SARS go over they are thinking that it may help the same wave this are co2 as well so that is what is going on with chloroquine then is the second drug is the rammed a severe Ram Dass severe is also a an antiviral again not for sorrow of 2 virus but they are hoping that this would work and what the the way this drug functions is that the corona virus or the Asarco of two carries an enzyme with it so let's say this is an enzyme it carries with it this is called RNA dependent RNA polymerase this enzyme when the virus goes in our cell this enzyme does the first function to make copies of the RNA or miss it creates messenger RN from the existing are any of the virus and then the copies start Ram desi where blocks this enzyme of the virus so this enzyme cannot make messenger RNA and then the virus cannot become replicated and somehow so by this mechanism the virus replication or division not division multiplication reduces or stalls so that is the way Ram des aveer work in general as an antiviral they are hoping that it could work for the corona or SARS of two as well so this is the summary of signs and symptoms and management supportive management from mild cases our stay at home stay hydrated you may take Paris tamal for for fever you may take cough syrups you may have to take lots of water 810 glasses of water stay well fed and just take rest 81 percent of the cases you'll become find in the remaining cases you may need to go to hospital again for 14 percent of the cases you would need oxygen 3-4 weeks in the hospital in your find in five percent of the cases there may be ventilation and there are folks out of that that unfortunately may not make it so please make sure that you do not come in contact with older people because they are at a higher risk so do not put the mattress there your parents their grandparents your family friends colleagues whoever the strangers don't put them at risk if you're a youngster this is your responsibility because you may have infection if you're a youngster you may be giving it out you may be asymptomatic and or very mild symptoms enough model that you won't even think to go to the daughter but in that process you might make others sick which may lose their life if you are not careful so just be very careful.

Note--- these blog are only for general information not any advice and not expert advice so if you have any symptom consult to medical expert.

WHEN IS THE END ?

#COVID19